Irvine Therapy Services

Using sensory integration to help children succeed since 1980

UNDERSTANDING

AROUSAL

REGULATION

SENSORY PROCESSING

PRAXIS

WHAT IS AROUSAL?

Arousal can be considered a state of the nervous system describing how alert one feels. In order to attend, concentrate, and perform tasks in a manner suitable to the situational demands, one’s nervous system must be in an optimal state of arousal for that particular task. Self-regulation is the ability to attain, maintain, and change arousal appropriately for a task or situation. Most individuals self-regulate their arousal levels throughout the day, with no conscious thought or effort. In the morning when they wake up, they are able to move from a low arousal state (sleep) to an optimal level so they can focus on the day’s activities. And when the day is done, they are able to move back down to a low arousal state in order to fall asleep.

Arousal levels can mildly fluctuate throughout the day in response to various sensory events (ex. a car honking on the freeway or burning a hand on a hot pan may momentarily startle, eating too much for lunch may produce a brief food coma) , but most individuals are usually able to self-regulate so that their arousal stays within an optimal zone. Some individuals, however, are unable to self-regulate their arousal level and may 1) have low arousal throughout the day (ex. cannot seem to get going, lethargic, slow, usually sedentary), 2) have high arousal throughout the day (ex. seems unable to calm down, hyperactive, seemingly minor incidents result in major meltdowns, fight or flight response, becomes overwhelmed and freezes or shuts down), or 3) have large fluctuations throughout the day ranging from very low to very high arousal.

(parts taken from How does your engine run?: A leader’s guide to the Alert Program for self-regulation, Mary Sue Williams & Sherry Shellenberger, 1994)

Low Arousal

High Arousal

WHAT IS REGULATION?

“Regulation is the ability to attain, maintain and change arousal appropriately for a task or situation.” From ‘How Does Your Engine Run’ by Williams, Shellenberger, 1994. Regulation starts to be developed in infancy as the child learns to regulate body functions including the regulation of temperature, sleep wake cycles and continues with the ability to self soothe, coordinate eating and breathing etc. As the child matures, regulation includes the ability to problem solve, change arousal levels to meet environmental demands, respond to stress and cope with the demands of time, space and tasks. It includes the ability to use higher level executive functions and organizational skills. Regulating attention and emotions, managing stress and coping with the normal demands of life are predicated on efficient self regulation.

When our brain efficiently receives, interprets and perceives sensory information from our world, including information from the hidden senses of vestibular and proprioception, and the eighth sense of interoception, we develop emotional stability, and are able to efficiently regulate attention, develop a body percept (or internal map of our body) and plan motor actions. This is necessary to enable us to engage meaningfully with people and the world around us. As we learn to effectively navigate our world, we develop self esteem, self control and self confidence. These foundational expressions then allow us to develop executive functions, including the ability to think, learn, behave and interact socially with others. Thus, we can see that effective sensory integration is foundational to a well regulated, balanced and happy individual. In its most basic sense then, regulation can be said to be the end product of efficient sensory integration. Many children with attentional disorders (ADD, ADHD) Autism, Sensory Processing Disorder, Learning Disability, etc. have at their foundation, difficulty with sensory processing that may include trouble interpreting, perceiving and integrating sensory information.


“Interoception is a key component of our emotional experience” shares Kelly Mahler, MS, OTR/L in her book ‘Interoception: The Eighth Sensory System.’ Interoception is that sense that helps us feel about the inside of our body. It signals to us the feelings of hunger, thirst, pain, body temperature, heart rate, social touch, itch, tickle, sleepiness, need to use the bathroom etc.

Low Arousal

High Arousal

WHAT IS SENSORY PROCESSING?

Sensory Processing Disorder (SPD) is a complex disorder of the brain that affects developing children and adults who were not treated in childhood. It has also been referred to under different names such as sensory integration disorder or dysfunction of sensory integration. Children with SPD misinterpret everyday sensory information, such as touch, sound, and movement. Some feel bombarded by sensory information; others seek out intense sensory experiences or have other problems. This can lead to behavioral problems, difficulties with coordination, and other issues. Symptoms of SPD, like those of most disorders, occur within a broad spectrum of severity. While most of us have occasional difficulties processing sensory information, for children and adults with SPD, these difficulties are chronic, and they disrupt everyday life. Sensory signals don’t get organized into appropriate responses. Pioneering occupational therapist and neuroscientist A. Jean Ayres, PhD, likened SPD to a neurological “traffic jam” that prevents certain parts of the brain from receiving the information needed to interpret sensory information correctly. A person with SPD finds it difficult to process and act upon information received through the senses, which creates challenges in performing countless everyday tasks. Motor clumsiness, behavioral problems, anxiety, depression, school failure, and other impacts may result if the disorder is not treated effectively. Sadly, misdiagnosis is common because many health care professionals are not trained to recognize sensory issues.

Sensory Processing Disorder can affect people in only one sense–for example, just touch or just sight or just movement–or in multiple senses. One person with SPD may over-respond to sensation and find clothing, physical contact, light, sound, food, or other sensory input to be unbearable. Another might under-respond and show little or no reaction to stimulation, even pain or extreme hot and cold. In children whose sensory processing of messages from the muscles and joints is impaired, posture and motor skills can be affected. These are the “floppy babies” who worry new parents and the kids who get called “klutz” and “spaz” on the playground. Still other children exhibit an appetite for sensation that is in perpetual overdrive. These kids often are misdiagnosed – and inappropriately medicated – for ADHD.

Sensory Processing Disorder is most commonly diagnosed in children, but people who reach adulthood without treatment also experience symptoms and continue to be affected by their inability to accurately and appropriately interpret sensory messages. These “sensational adults” may have difficulty performing routines and activities involved in work, close relationships, and recreation. Because adults with SPD have struggled for most of their lives, they may also experience depression, underachievement, social isolation, and/or other secondary effects.

[From the Sensory Processing Disorder (SPD) Foundation]

SENSORY PROCESSING AND TOUCH

WHAT IS MOTOR PLANNING (PRAXIS)?

Praxis is comprised of three components:

1) ideation-the ability to conceptualize a new or different activity

2) motor planning-the ability of the brain to organize and sequence novel motor actions

3) execution-the ability to perform motor actions

When children have dyspraxia, or difficulties with praxis, there is often a deficit in the motor planning component. Underlying that deficit is frequently poor processing of tactile, proprioceptive and/or vestibular sensory input. These three sensory systems are foundational for the development of a body percept. A. Jean Ayres discusses how forming neural memories to create a body percept is essential for motor planning in her book Sensory Integration and the Child, 25th Anniversary Edition. As children move and interact with their environment, their bodies store sensory information about their body parts—size, weight, boundaries, movements, and positions in relation to the rest of the body. The brain also stores information about the environment, such as gravity, texture, density, temperature, tensility, etc. Using the sensory information gleaned about his/her own body and incorporating the sensory information about his/her environment, the child is then able to know how fast and hard each muscle in his/her body needs to work in order to perform various tasks, how to properly use a tool, and if he/she will fall when performing a specific movement. Children with dyspraxia are often considered clumsy or awkward, and frequently have physical accidents because they lack an adequate body percept.

For most people, motor planning requires no conscious effort, they just do it. Their brains are able to do the work (motor plan) spontaneously. They might need to practice initially when learning something new, but the brain adapts; motor planning is no longer needed (remember, motor planning involves novel actions), and the action becomes automatic. For children with dyspraxia, the action does not become automatic, and they have to motor plan it over and over again. Dyspraxic children work very hard, more than other children, just trying to keep up. Subsequently, children with dyspraxia are frequently frustrated and anxious.

WHAT IS SENSORY PROCESSING DISORDER

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